Medicare aims to boost ‘people skills’

By Matthew Heimer

Researchers have known for a while that your doctor’s poor people skills can be hazardous to your health. Physicians who don’t listen carefully to a patient’s concerns, or who can’t describe a diagnosis or treatment strategy in terms a patient can understand, can contribute to serious problems ranging from misuse of medications to post-surgical complications and relapses. Cumulatively, the communication breakdowns become costly for the health-care system – and, of course, potentially catastrophic for the patient.

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Aiming for a better bedside manner.

This week, Wall Street Journal health columnist Laura Landro looks at one effort to use the financial muscle of Medicare to address some of these problems. Relatively new Medicare rules enable hospitals to earn payments if they score well on patient-satisfaction surveys that take doctor-patient communication into account. Another set of rules enforces financial penalties if hospitals wind up readmitting too many patients too soon after treatment– a problem that public-health experts say is often attributable to poor information-sharing. And one impact of these carrot-and-stick incentives is that hospitals are spending more money on role-playing, seminars and coaching to train and retrain their doctors in “soft” skills.

It’s too soon to know whether the rules are succeeding on a nationwide level; Landro’s article focuses anecdotally on a couple of hospital systems that have seen some improvement in their patient-satisfaction scores. But her piece does make clear that hospital administrators are buying into the idea that an investment in communications training can pay off down the line. She also conveys the idea that it isn’t easy for doctors to find a balance between conveying their medical judgment and treating patients considerately—especially in situations where patients have “conditions with no good treatments or cure.” As one doctor asks rhetorically, “How do I do my best when I know it is not going to end well, but I am being judged with making sure patients are happy or satisfied?”

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Encore looks at the changing nature of retirement, from new rules and guidelines for financial security to the shifting identities, needs and priorities of people saving for and living in retirement. Our lead blogger is editor Matthew Heimer, and frequent contributors include editor Amy Hoak, writer Catey Hill, and MarketWatch columnists Elizabeth O’Brien, Robert Powell and Andrea Coombes. Encore also features regular commentary from The Wall Street Journal retirement columnists Glenn Ruffenach and Anne Tergesen and the Director of the Center for Retirement Research at Boston College, Alicia H. Munnell.